Classification and Treatment of Urticaria: A Brief Review

Kjetil Kristoffer Guldbakke, MD; Amor Khachemoune, MD, CWS

Disclosures

Dermatology Nursing. 2005;17(5):361-364. 

In This Article

Angioedema Without Wheals

Hereditary Angioedema

It is useful to classify angioedema occurring without wheals as a separate entity, as its etiology may be associated with hereditary angioedema, which must be excluded. The condition is usually idiopathic or due to drug reaction to ACE inhibitors, aspirin, or NSAIDs. Hereditary angioedema is a rare autosomal dominant condition with a prevalence of 1:10,000 to 1:150,000 in the general population, caused by a deficiency (type I, 85%) or dysfunction (type II, 15%) of C1 esterase inhibitor (Zuraw, 2005). Low levels of C4 in the serum is a constant and diagnostic feature. Patients suffer from life-long episodic angioedema, may experience colicky abdominal pain, and laryngeal involvement can be life threatening. Treatment is difficult, involving fluid replacement and C1 esterase inhibitor concentrate for acute attacks (not approved in the U.S.) and prophylactic treatment with anabolic androgens and antifibrinolytics.

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